花都区医院控烟工作调查及结果分析

目的分析花都区医院控烟工作调查结果,评价其控烟效果,为进一步制定控烟政策提供依据。方法采用随机抽样方法,在花都区随机抽取5家医院作为调查对象,对调查对象的负责人进行访谈,并从每个调查对象中随机抽取20名工作人员进行问卷调查,综合运用观察法和PM2.5浓度监测,评估控烟立法前后医院控烟效果的变化。结果医院工作人员烟草危害知识知晓率高(均为100%),吸烟率(2=0.46,P>0.05)与二手烟暴露状况的变化无统计学意义(2=2.27,P>0.05),对控烟立法支持率(2=24.25,P<0.01)和法规遵守率(2=36.74,P<0.01)明显提高;医院各项控烟措施得到有效落实(2=6,P<0.05);医生办公室PM2.5浓度降低(T=7,P<0.05),洗手间、大厅、护士工作站PM2.5浓度变化无统计学意义(T分别为12、22、14,P>0.05)。结论医院大环境公众吸烟与二手烟暴露状况仍未改善,应加强控烟工作的组织领导、公益宣传及加大执法处罚力度,推动建立无烟大环境,并把烟草PM2.5浓度标准列入控烟立法,作为执法依据。     

珠海市室内公共场所无烟环境建设与空气PM2.5现状调查

目的通过室内公共场所吸烟基本情况调查和空气PM2.5检测,了解珠海市室内公共场所空气质量与吸烟的关系,为珠海市室内公共场所无烟环境建设和控烟立法提供依据。方法通过现场观察珠海60家公共场所控烟环境建设及室内吸烟行为情况,结合室内外空气PM2.5水平监测,了解珠海市室内公共场所控烟现状及室内空气质量。结果在无烟环境建设的禁烟标志张贴、禁烟政策、吸烟区设立以及室内吸烟各方面,医疗机构、学校、政府单位、公共交通场所整体均好于餐厅、旅店、歌舞厅/酒吧。结论提示今后珠海市控烟宣传和室内禁烟工作的重点、难点是餐厅、旅店、歌舞厅/酒吧此类场所室内有吸烟现象的场所室内外PM2.5浓度差明显高于无吸烟现象者,差异有统计学意义(P0.05),提示室内场所全面禁烟有助于降低室内PM2.5浓度。     

南昌市部分公共场所二手烟暴露现况调查

目的了解南昌市部分公共场所的二手烟暴露情况。方法对南昌市医院、学校、政府机构、疾控机构和公共交通场所共101家场所进行现场观察,对场所内的1 870名工作人员和来访者进行问卷调查,并监测市区场所室内空气中的PM2.5浓度。结果被调查的101个场所中,15.8%为全面禁烟场所,20.8%有禁烟标志,18.8%有控烟宣传栏,但在公共场所吸烟现象仍比较普遍。非吸烟工作人员中,有37.1%在工作场所受到二手烟的侵害,不同类型场所的工作人员二手烟暴露率间差异有统计学意义(P<0.001)。不同场所类型空气中PM2.5的平均浓度不同,差异有统计学意义(P=0.023),其中公共交通场所室内空气中PM2.5的浓度最高,其值高达122.98μg/m3;学校、政府和疾控机构相对较低。影响室内PM2.5浓度的因素包括室内吸烟人数和场所1公里内有工地,其中室内吸烟人数影响较大。结论公共场所吸烟现象严重,二手烟暴露率高,禁烟措施不完善,执行力度不够。需要加强宣传教育,同时出台符合《烟草控制框架公约》的地方法规。     

广州市工作和公共场所室内空气PM2.5浓度调查

目的 了解广州市主要的公共场所和工作场所室内PM2.5浓度水平和影响因素,为制定相关卫生标准及政策法规提供科学依据.方法 通过分层抽样方法抽取10类工作场所及公共场所,使用AM510便携式防爆智能数字粉尘仪进行30 min室内空气PM2.5的浓度检测,通过单因素以及多重对应分析等方法对室内PM2.5浓度的影响因素进行分析.结果 全市各类场所室内PM2.5平均浓度为61.17 μg/m3,其中长途汽车站、火车站等交通场所以及酒店、宾馆等食宿场所浓度较高,均值分别为98.80和76.59 μg/m3；单因素分析显示,与中心城区相比,县级市场所的PM2s浓度水平相对较低(Dunnett-t=-0.19,P=0.003).闻到油烟味或发现有人正在吸烟的场所的PM2.5浓度水平均高于未发现的(t=3.03,P=0.003；t=2.19,P=0.031)；多重对应分析结果显示,室内PM2.5浓度高多与食宿或者交通场所、无禁烟标识、吸烟行为、闻到油烟有关.结论 广州市各类场所室内PM2.5浓度水平较高,在酒家、饭店等餐饮场所以及长途汽车站等交通站点污染较严重,应加强对这类场所的监管,保护公众健康.     

广州市办公大楼室内空气PM2.5浓度调查与分析

目的了解广州市办公大楼室内空气PM 2.5浓度水平和影响因素,为制定相关卫生标准及政策法规提供科学依据。方法选择广州市58家办公大楼进行PM 2.5浓度监测。每家办公大楼选取办公大厅、领导办公室、复印室、男洗手间4个监测区域,在每个区域的中央设置1个监测点,并设室外对照监测点1个,于办公时间进行监测。结果男洗手间的PM 2.5浓度最高,为(95.20±60.36)mg/m3;其次是领导办公室,为(78.53±63.72)mg/m3;浓度最低的是办公大厅,为(45.61±27.56)mg/m3,不同监测区域PM 2.5浓度差异有统计学意义(F=4.26,P0.05)。男洗手间、领导办公室PM 2.5浓度均显著高于室外,差异有统计学意义(F=6.33,P0.05)。结论男洗手间和领导办公室PM 2.5污染较为严重,可能与吸烟有关。应加强室内禁烟宣传及监督,控制PM 2.5污染。     

河南省医疗卫生机构室内PM2.5浓度监测

目的:通过对室内PM2.5浓度进行监测,比较河南省不同医疗卫生机构室内烟草烟雾污染情况。方法:在河南省东、西、南、北、中5个区域分别选择1个市,将其卫生局、疾病预防控制中心(简称疾控中心)、医院、妇幼保健院共38家医疗卫生机构作为监测对象,采用气溶胶监测仪对室内、外PM2.5浓度进行监测,并记录室内监测场所的容积、场内人数、正在吸烟人数。结果:4类医疗卫生机构室内PM2.5平均浓度为(87.4±15.1)μg/m3,卫生局、疾控中心、医院、妇幼保健院分别为(71.8±15.5)、(71.3±14.3)、(103.8±16.9)、(51.4±11.3)μg/m3。室外PM2.5平均浓度为(68.9±12.5)μg/m3,室、内外比较差异有统计学意义(t=6.585,P<0.001),室内比室外高27.9%。医院、妇幼保健院室内PM2.5浓度均高于室外(t=6.659、5.383,P均<0.05)。室内PM2.5浓度与室内吸烟者密度、室外PM2.5浓度均呈正相关(r s=0.524、0.426,P均<0.001)。结论:在无烟医疗卫生系统的创建和管理上,应把医院及妇幼保健院作为控烟重点。     

银川市2010年控烟重点人群吸烟状况及控烟态度调查

目的了解银川市控烟重点人群及公共场所的吸烟状况及影响因素,为评估《银川市公共场所控制吸烟条例》实施效果、推进银川市控烟进程提供科学依据。方法 2010年7～8月在医院、学校、行政机关对大中小学生、教师、医务人员、公务员四类人群进行一对一现场问卷调查,调查问卷由《盖茨中国控烟项目》统一提供。每个区四类人群各选择200人,共2400人。共收集到2000份问卷,其中,有效问卷为1811份,教师601份,医生604份,公务员606份。结果 (1)调查人群吸烟率为23.14%,其中男性吸烟率为46.11%,女性吸烟率为2.9%,性别间差异有统计学意义(χ2=473.71,P<0.05);(2)不同职业调查,医生吸烟率为17.7%,公务员最高为30.70%,教师为21.00%,差异有统计学意义;(3)平均每日吸烟量公务员为24支/天,教师为23支/天;(4)对于控烟规定的执行情况医院执行较好,占调查总数的50%,学校和机关相对较差,分别为38.7%和32.4%。结论银川市控烟重点人群中公务员吸烟率相对较高;应对控烟重点人群加大吸烟危害健康知识的宣传教育,提高其对烟草危害的认知及重视。     

长春市公共场所室内环境尼古丁浓度监测分析

目的:监测长春市公共场所室内环境中尼古丁浓度,以分析室内环境烟草烟雾的污染情况,为全面开展控烟和卫生监管提供科学的依据。方法:采用被动式尼古丁采样器对各监测点的尼古丁浓度进行监测,随机在长春市五个城区,选择27个单位四类109个有代表性的公共场所开展监测。结果:尼古丁检出率为92.66%,其浓度中位数为0.495μg/m3,浓度范围为0.000~13.001μg/m3;不同类型公共场所尼古丁浓度差异有统计学意义(H=23.336,P0.001),宾馆检测到的尼古丁浓度中位数最高,其次是医疗机构;不同单位监测点中,尼古丁浓度男性卫生间均最高,中位数为1.372μg/m3,不同单位空气中尼古丁浓度差异有统计学意义(H=46.977,P=0.001);各单位中尼古丁浓度中位数范围为0.000~3.169μg/m3,空气尼古丁浓度中位数超过0.5000μg/m3的单位占44.4%。结论:宾馆、医疗机构尼古丁含量均较高;各单位男性卫生间、宾馆大厅及房间是尼古丁污染的重点场所。     

公共场所PM10和PM2.5浓度及其对从业人员上呼吸道症状的影响

目的了解广州市黄埔区各类公共场所室内PM10和PM2.5浓度水平及对从业人员上呼吸道症状的影响。方法通过分层抽样方法抽取全区4大类公共场所,包括理发美容类、商场剧院类、酒店旅馆类、酒吧KTV游戏厅类,采用便携式防爆智能数字粉尘仪AM510进行室内PM10和PM2.5浓度检测,通过单因素分析方法对各类场所室内PM10和PM2.5浓度水平进行分析。结果黄埔区4大类场所室内PM10浓度水平分别为(0.113±0.044)mg/m3,(0.085±0.022)mg/m3,(0.112±0.028)mg/m3和(0.207±0.031)mg/m3,其中酒吧KTV游戏厅室内PM10浓度超出GB/T 18883-2002标准限值(<0.15mg/m3)。全区4大类场所室内PM2.5浓度水平分别为(0.065±0.025)mg/m3、(0.050±0.013)mg/m3、(0.075±0.016)mg/m3和(0.120±0.018)mg/m3,均超出GB 3095-2012一级标准限值(<0.035mg/m3)。单因素分析及两两比较结果表明:各类场所室内PM10和PM2.5浓度水平,酒吧KTV游戏厅类最高,商场剧院类最低,差异具有统计学意义(P<0.05)。PM2.5浓度与咳嗽、咽痛和鼻炎发生率呈正相关。结论黄埔区4大类公共场所室内PM2.5污染较为严重,明显影响从业人员上呼吸道健康,应加强对这类场所监管。     

江阴市酒吧歌厅空气中甲醛监测与分析

目的了解我市酒吧歌厅空气中甲醛的浓度,保障人民身体健康。方法依据GB/T17220-1998《公共场所卫生监测技术规范》对20家大型酒吧歌厅进行空气中甲醛测定,并按GB9664-1996《文化娱乐场所卫生标准》进行评价。结果酒吧歌厅空气中甲醛浓度总平均值为0.099mg/m3,总超标率为22.5%;大型酒吧歌厅下午甲醛浓度平均值为0.099mg/m3,晚上为0.100mg/m3。差异无统计意义(t=0.11,P0.05);大厅内空气中甲醛浓度平均值为0.084mg/m3,包厢内平均值为0.114mg/m3,差异有统计学意义(t=3.32,P0.005);使用中央空调的空气中甲醛浓度平均值为0.118mg/m3,无中央空调的平均值为0.077mg/m3,二者差异存在显著性(t=3.82,P0.005);新装修的空气中甲醛浓度平均值为0.124mg/m3,未装修的平均值为0.083mg/m3,二者统计学上有显著性差异(t=3.82,P0.005)。结论我市酒吧歌厅中甲醛污染较为严重,建议加大监管力度,使用低甲醛环保的装饰材料,降低公共场所空气中甲醛含量,确保工作人员和消费者的身心健康。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.